New guidelines released for management of hyperbilirubinemia in newborns.

2004 AUG 5 - (NewsRx.com & NewsRx.net) -- The American Academy of Pediatrics (AAP) has released new guidelines for the treatment of neonatal jaundice.

The guidelines were promulgated by the AAP Subcommittee on Hyperbilirubinemia and published in the July issue of Pediatrics (Pediatrics 2004; 114:297-316). These new guidelines entitled: "Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation" supersedes earlier guidelines published in 1994.

In publishing these new guidelines the AAP has increased its recommendations for vigilance of newborns for development of severe jaundice and prevention of kernicterus (brain damage secondary to severe jaundice) during the immediate postpartum period while in hospital and awaiting discharge.

Recommendations are made for intervention earlier than recommended previously by the old guidelines and are based on serum or transcutaneous bilirubin measurements.

The guidelines state on page 298:

"The overall aim of this guideline is to promote an approach that will reduce the frequency of severe neonatal hyperbilirubinemia and bilirubin encephalopathy and minimize the risk of unintended harm such as increased anxiety, decreased breast feeding, or unnecessary treatment for the general population and excessive cost and waste. Recent reports of kernicterus indicate that this condition, although rare, is still occurring.

"Analysis of these reported cases of kernicterus suggests that if healthcare personnel follow the recommendations listed in this guideline, ...